In the Journals

HIV associated with increased risk for age-related events

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November 11, 2014

Adults with HIV demonstrated a greater risk for age-associated events, including myocardial infarction, end-stage renal disease and non–AIDS-defining cancers, but at similar ages compared with adults without HIV, according to new data.

“These findings should reassure HIV-infected patients that they are unlikely to experience these conditions decades earlier than those aging without HIV,” the researchers wrote in Clinical Infectious Diseases. “Continued investigations of the mechanisms of the HIV effect on age-associated conditions, and impact of lifestyle interventions on aging-associated disease risk, are needed to inform clinical management of adults aging with HIV.”

Keri N. Althoff, PhD, MPH, assistant professor at Johns Hopkins University Bloomberg School of Public Health, and colleagues used data from the Veterans Aging Cohort Study to determine the mean age at diagnosis for MI, end-stage renal disease (ESRD) and non–AIDS-defining cancers (NADC) among a cohort of 98,687 adults. The cohort included 30,564 adults with HIV and 68,123 without HIV. The researchers also evaluated whether adults with HIV had a greater risk for these conditions.

The MI analysis included 83,527 adults and 453,982 person-years of follow-up. There were 291 MI events among adults with HIV and 398 among uninfected adults. There was no difference in age at diagnosis. After adjustment, the risk for MI was greater among adults with HIV compared with uninfected adults (HR=1.76; 95% CI, 1.49-2.07).

The analysis for ESRD included 97,922 adults and 583,178 person-years of follow-up. There were 447 events among adults with HIV and 688 events among uninfected adults. The mean age at diagnosis was 56 years for adults with HIV and 59.4 years for uninfected adults. After adjustment, adults with HIV were diagnosed with ESRD 5.5 months younger than uninfected adults, a mean difference of –0.46 (95% CI, –0.86 to –0.07). Age-stratified crude incidence rates showed that adults with HIV had higher rates of ESRD at all ages.

Lastly, 96,417 adults contributed 519,632 person-years of follow-up for the NADC analysis. There were 1,471 events among those with HIV and 2,708 among uninfected adults. There was no difference in age at diagnosis, but age-stratified crude incidence rates indicated there was a significantly higher rate of NADC among adults with HIV at all ages.

“Our findings suggest traditional risk factors do play an important and independent role in aging-associated diseases,” the researchers wrote. “Many traditional risk factors were associated with a greater magnitude of risk compared with HIV in multivariate models. Targeting traditional risk factors may help decrease the excess burden of aging-related diseases among HIV-infected adults.”

Disclosure: Some researchers report financial relationships with Bristol-Myers Squibb, Merck and Tibotec.

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